About the service

Shortwood House is a care home that offers care and support to up 12 older people, some of whom are living with dementia. There were 10 people using the service at the time of our visit.

At our last inspection in October 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

People’s experience of using this service

• People were very happy living at Shortwood House. They felt safe and liked the staff who supported them. Relatives were very satisfied with the service and they felt welcomed when they visited and said that staff contacted them to inform them of any changes. Staff were proud to be working at the service and enjoyed their job. Everyone said they would recommend the home.

• Everyone praised the care manager and the provider and said they were approachable and supportive. There were enough staff to meet people’s needs in a timely way. Staff went through a thorough recruitment process so the provider knew they only employed suitable staff

• The provider had systems in place to keep people safe from avoidable harm. Staff knew who to report any concerns to and risk was identified and managed so that people were as safe as possible. Staff had received the training they required so they had the knowledge and skills to do their job and meet people’s needs.

• Staff gave people their prescribed medicines safely. They followed good practice guidelines to help prevent the spread of infection. People had access to the healthcare services they required.

• There was a variety of nutritious meals based on people’s choices and nutritional needs. Staff were flexible so they could meet people’s individual needs.

• People made choices in all aspects of their lives. Staff knew each person well, including their likes and dislikes and their preferences about how they wanted staff to care for them.

• Staff respected people’s privacy and dignity and encouraged people to be as independent as possible. People had opportunities to decide on the care they wanted and to review and change the care if it was not meeting their needs.

• The staff team were all involved in arranging a wide range of activities for people to do. They organised group and individual activities.

• People knew how to complain and were confident that the care manager would resolve their complaints.

• There were effective quality monitoring processes in place including seeking the views and feedback of people who used the service and their relatives. Shortwood House was homely and staff did everything to make people’s lives as comfortable and fulfilling as possible.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service Good (report published October 2015).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 30 October 2015 and was unannounced.

Accommodation for up to 12 people is provided in the home over three floors. There were 12 people using the service on the day of our inspection. The service is designed to meet the needs of older people.

There is a registered manager and she was available during the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to manage risks and respond to accidents and incidents. The premises and equipment were checked to keep people safe. Sufficient staff were on duty to meet people’s needs and they were recruited through safe recruitment practices. Medicines were safely managed.

Staff received appropriate induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate and adaptations had been made to the design of the home to support people living with dementia.

Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care.

People’s needs were promptly responded to. Care records provided sufficient information for staff to provide personalised care. Activities were available in the home. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved in the development of the service. Staff told us they would be confident raising any concerns with the management and that the registered manager would take action. There were systems in place to monitor and improve the quality of the service provided.

This inspection was carried out by one inspector. We met everyone who lived at Shortwood House. One person was cared for in bed. There were 11 people living at the home at the time of our visit. We observed care being provided but were not able to speak with everyone. We spoke with four people who used the service and asked them about their experience of living at Shortwood House. We also examined care plans and other records. We spoke with the provider, manager and three care staff working at the service.

We last inspected this service on 30 July 2013. At that time we found the service had a complaints system in place. However comments and complaints people made were not always responded to appropriately. At this inspection we found the service had introduced a complaints log which recorded concerns and how these were resolved. We used the evidence we collected during our inspection to answer five questions. A summary of what we found is set out below.

Is the service safe?

We spoke with one person who told us, “This is a lovely place. I was so afraid I wouldn’t find anywhere I would feel safe. We are beautifully looked after."

The service protected people who were unable to make decisions, for example, about their finances. The service used Deprivation of Liberty Safeguards which are a legal framework designed to ensure that the care people receive does not unlawfully deprive them of their liberty. The process followed by the service met the requirements of the Mental Capacity Act 2005. There were no Deprivation Of Liberty Safeguards (DoLS) in place at the time of our inspection. The home had obtained a DoLS authorisation for a person who had recently moved to another service. The person tried to leave the building but was unaware of the risks, because of their condition.

We found contracts were in place for maintaining fire detection systems and the lift which enabled people to reach the first floor of the home. The home’s central heating service was regularly inspected by a service engineer. We saw they had raised a concern about the safety of the system which had not been resolved. We did not see a risk assessment had been carried out.

Is the service effective?

We looked at four people’s care plans and found their needs had been assessed. This included identifying risk, for example, of falling or developing pressures sores. Daily records recorded how the service supported people at risk, for example, by re-positioning the person every two hours. We found care plans and risk assessments were reviewed. The manager had a schedule of care plan reviews which showed when the reviews were planned or had taken place.

One person required a special diet because their condition meant they could not eat food containing gluten. Guidance for staff was available in the kitchen and in the person’s care plan.

Care plans showed the service had discussed people’s wishes for the end of life and plans had been agreed with relatives about the person’s preferred place of death.

Is the service responsive?

One person told us, “I have had my hair done and I feel so much better." We asked one person how long staff took to respond to the call assistance alarm. They said, “Staff are pretty good at responding."

We spoke with the provider who told us they were a dignity champion for the service. They described how they were part of a national organisation which promoted dignity in care homes.

Is the service caring?

The manager told us the service was providing support for a married couple. One partner had lived in another home. When a place became available the manager arranged for the person to join their partner. One person we spoke with told us, “I have been feeling really low recently. Staff take me out for a few hours and it takes my mind off things.” We saw care staff comfort and reassure the person when they were upset.

Care staff we spoke with told us they had time to care for people, for example, by talking to them as well as carrying out caring tasks.

Is the service well led?

The owner had developed a quality assurance process which consisted of audits and checks designed to identify and manage the risks to people ‘s health and welfare. The service had also obtained feedback from people who used the service, relatives and staff.

Care staff were supported with training and supervision from their manager. We saw the manager discussed people’s knowledge about supporting people, for example with dementia, as part of care staff supervision meetings.

There were systems in place for identifying and managing risk but we found examples of risks which were not being managed effectively.

Relatives of people who used the service told us, “We’re involved in our relative’s care and their care plan. We have regular meetings with the manager to discuss our relative’s care needs.”

We looked at the care plans of three people who used the service and saw that each person’s care plan contained detailed information about themselves and their personal likes and dislikes.

We spoke with two people who used the service who told us, “The staff are wonderful and they work hard.”

We spoke with an external health care professional who said, “I’ve no concerns about the service.”

One staff member told us, “The home is very clean, it’s rare that we have any odours.”

During our inspection, we saw the home was clean and procedures were in place to maintain the home’s cleanliness.

Since our last inspection, we found that the service had taken action to ensure there were effective recruitment and selection processes in place. We looked at three staff files and saw these contained proofs of identification and two references for each new member of staff.

We looked at the complaints register. The service did not have a summary of received complaints, their outcomes and the timescales for the resolution of received complaints.

We discussed comments received by the service from a relative of a person who had used the service. Although the service had responded to the relative, the service had failed to identify that the relative wished to make a complaint.

During our visit we spoke with two people who were using the service and a visitor. The people we spoke with told us staff would always seek their consent before carrying out any personal care. One person said, “Staff are always very polite, they ask what I want and they respect what I say. If I want to stay in bed a bit longer then I can.”

During the lunch time period we saw that everybody received their meals at the same time. Those people who needed support to eat their meals received this support in a calm and unhurried manner. Staff were attentive to other people’s needs as well without being intrusive. This meant that the lunchtime period was relaxed and enjoyable for everybody using the service.

During our visit we spoke with two people who were using the service and a visitor. The people we spoke with told us they felt safe living at the home and had no concerns.

During our visit we spoke with two people who were using the service and a visitor. The people we spoke with told us they were happy their views and opinions were taken seriously by the manager. The visitor we spoke with provided an example whereby the manager had taken action to resolve a matter they had raised.